Digital Technologies as Tools to Screen and Monitor Alzheimer's Disease (AD) and Related Dementias (ADRD)

Number of anticipated awards: 3 Budget (total costs, per award): Phase I: $500,000 for 12 months; Phase II: $ 2,500,000 for 2 years Fast Track proposals will be accepted: Yes Direct to Phase II proposals will be accepted: No It is strongly suggested that proposals adhere to the above budget amounts and project periods. Proposals with budgets exceeding the above amounts and project periods may not be funded. Summary: Alzheimer's Disease (AD) and related dementias (ADRD) represent a major public health issue in the USA, which is predicted to be even a bigger problem with the growing aging population. Currently, there is no cure for these diseases. AD/ADRD are managed symptomatically, and the disease-modifying treatments have become available only recently. Significant gaps have been identified that have prevented effective management and treatment of AD/ADRD. These gaps are related to i) screening, ii) early detection, iii) enrollment in clinical trials, iv) monitoring, and v) evaluation of the treatment effectiveness. There is unmet need to develop tools that can fill these gaps. Currently, AD/ADRD is identified when a patient presents with memory loss, the first symptom of otherwise a pathologically advanced state. There is further decline in cognitive performance leading to total dependency of patients on the caregivers. There are several established tools used to conduct cognitive assessments to evaluate neuropsychological domains such as memory, language, executive function, abstract reasoning, attention, and visuospatial skills. No single screen is universally accepted and comparative validity of the brief cognitive assessment tools in diverse populations is lacking. Recently, there has been interest in the development of medical devices and digital technologies to evaluate cognitive impairment in elderly caused by an underlying medical condition rather than as a part of the normal aging. Medical devices and digital technologies, such as software, have advantage of consistency in administering the test and reproducibility of results. Analysis of gait, speech, eye movement, hearing etc. using mobile devices, for example, can provide cost-effective and simple tests that can detect the disease early and provide longitudinal data for monitoring the progress of the disease. However, to be universally accepted, these tools need to be standardized and validated in diverse population. This topic supports an unmet need for the development of tools for medical devices that can fill the gaps identified above in the management and treatment of AD/ADRD.